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Beta-blockers frequently are used to treat vasovagal syncope, the most common type of syncope. Evidence for the efficacy of beta-blocker therapy has come primarily from noncontrolled clinical trials. Three randomized clinical trials of a cardioselective beta-blocker (atenolol) have produced conflicting results. In this study, researchers compared the effectiveness of a lipophilic, nonselective beta-blocker (propranolol); a nonlipophilic, nonselective beta-blocker (nadolol); and placebo for treating vasovagal syncope.
Each of the 30 subjects (mean age, 41; 13 men) had recurrent vasovagal syncope and a positive tilt test before study enrollment. Patients were randomized to 1 of 6 serial combinations of the study drugs (propranolol, 20-40 mg th…